Hiding from yourself: the struggle to open up about mental illness

Many benefit from the support of friends and family

It took five suicides in 12 months for students to start speaking out about their experiences with mental illness. In blog posts, Daily Pennsylvanian op-eds, student groups, UA committee meetings and more, students made it obvious that mental health is an important and widespread concern.

But the movement only began in the wake of the student deaths — beforehand, few people were sharing stories of mental illness in an open forum.

Although each person’s experience with mental illness is unique, many tend to have one thing in common: a fear that they are not living up to the expectations set by themselves and others. For many, the journey to recovery involves finding the people who will support them — whether those people be family, friends or mental health professionals — even through the most difficult times.

‘We don’t talk about certain things’

In the summer after her freshman year, Marlene’s dinner often consisted of the free granola bars she took from the place she worked. She paid her own rent and knew each dollar she made was essential.

“When I was a freshman, I really wanted to rush for a sorority, but I had to pay dues, which I couldn’t afford,” said Marlene, whose name has been changed for confidentiality — as have the names of others who are referred to by a first name in this article. “So I had to completely cut that option out of my life.”

Marlene found herself cutting many options out of her life — an act that she now realizes contributed to her loneliness and depression.

A major factor associated with depression is a feeling of isolation, which can make it difficult for some to reach out about the problems they face. Bethany Cam, a College junior, has felt that isolation since one of her closest friends died from cancer her freshman year — the same disease that killed her father when she was 14 years old.

“From then on, I was a little afraid of getting close to people,” she said. “I was a lot more negative, I stopped hanging out with people, and I just hated the way that I was and the way that I looked.”

By her sophomore year, Cam’s weight had dropped to 95 pounds, a result of the anorexia she developed at Penn. Then, following a sexual assault, she fell into a severe depression. Her grades dropped dramatically, and she almost had to take a leave of absence because of the two F’s on her report card.

Although many factors influenced Cam’s feelings and actions at the time, she spoke extensively about the effects that feeling isolated had on her.

“I felt alone even with my friends and family around me,” she said. “I felt so worthless that some nights I cried myself to sleep.”

During her sophomore year, Cam tried to commit suicide.

“When I swallowed the pills, I felt this sense of relief that I didn’t have to deal with this anymore. But my body didn’t take it — I threw them up, and I was going to live,” Cam said. “That’s when it dawned on me that things weren’t as bad as I thought they were.”

For some people, isolation can begin by being cut off from the world — by losing loved ones or having no support networks in stressful situations — but loneliness can continue to grow as people worry about the consequences of sharing the way they feel with others.

Even though Cam wanted to feel better, she said, she tried to keep her friends from seeing that she needed help. “At Penn, there’s such a conception that you need to be perfect in every way, but we’re not all OK. Actually, most of us aren’t,” she said. “So I continued smiling and laughing and trying to act like everything was fine when it wasn’t.”

This made Cam feel even more lonely and depressed, she said, contributing to her ultimate decision to attempt suicide.

Like Cam, Marlene found it difficult to explain her depression — spurred by financial stress — to her friends. She was embarrassed to admit that she had any financial trouble at all.

“When other people want to go out or do something that I can’t afford, I’ll usually lie or make up an excuse, like, ‘I can’t go. I have work that night,’” she said. “We have this culture where we don’t talk about certain things. When I say, ‘I can’t go because of money,’ it comes off as whiny. I don’t want them to judge me.”

Only a few of Marlene’s friends know about her financial stress, because she feels too uncomfortable talking about it, and even fewer know about her resulting depression. “I’m afraid they’ll make a comment that isn’t supportive,” she said.

Many students worry about being judged by their friends and family for speaking up about their mental illness. Alex, a College freshman, has also had a difficult time trying to reach out about her depression.

Late in her first semester at Penn, Alex’s grandmother was diagnosed with cancer — the disease that had taken so many of her family members, including her mother when Alex was only 12 years old. Since her mother’s death, Alex has been struggling on and off with depression, something that only a few of her family members knew about by the time the school year started.

“I felt like I had to be the stronger one for my family, since I didn’t want to be dark or upset or let people see that I was sad,” Alex said. “I think that’s how it started growing.”

At Penn, Alex was in a constant struggle between devoting her time to her schoolwork and thinking about her family. As badly as she wanted to go home, she didn’t want to neglect her responsibilities at Penn.

Alex’s friends kept asking her questions about the way she was acting, wondering why she wasn’t her “normal, happy-go-lucky self,” Alex said.

“That’s so hard to hear. I felt like I was letting someone down — like I’m not this image of what I was going to be or what I was supposed to become,” Alex said. “I felt so guilty for showing them that I’m not this person all the time.”

Facing the emotional de mons

For many, the ultimate path to recovery from mental illness involves taking the step to open up to others, no matter how difficult that process can be.

For Ben Wieder, the process began by first admitting to himself that he had problems he needed to work on.

Wieder, a 2009 College graduate and current Ph.D. candidate in physics, didn’t wash his sheets for four months during his junior year at Penn. He would stay up until 5 in the morning playing video games, sleeping through the day and missing class.

“I used to brush my teeth every time I thought I’d meet a girl, so I brushed my teeth nine times a day and I actually eroded my gums,” Wieder said. “I had to get gum surgery this year just to fix it.”

When Wieder would go out to parties or pre-games, he said, the anxiety was so unbearable that he would sweat through his shirts and had to go back to his room to change.

Wieder’s roommate and his roommate’s girlfriend arranged a meeting for him at CAPS because they were concerned about his behavior. A CAPS therapist diagnosed Wieder with Obsessive Compulsive Personality Disorder, a mental illness that involves perfectionism and a need for orderliness.

“That’s when I realized some of these things were actually unhealthy,” Wieder said. “Somehow along the way I realized that I had been wearing the same undershirt and hadn’t left my room for two months.”

Wieder went to CAPS for the rest of his time as a Penn undergraduate. With help from his counselor, he was able to graduate with a double major in physics and biochemistry and bring his fencing team to its only sole-possession Ivy League championship win in over 20 years as the captain.

Despite the problems he faced, Wieder said he would never have gone to CAPS on his own. “I didn’t know I had a real mental health issue ... I wouldn’t have known where to go or what to do or exactly how to approach the situation,” he said. “It seemed like a last-ditch emergency situation to go there, so I think it was good [my friends] knew what they were doing and exactly the path of least resistance to getting me there.”

Many students hold the same perspective. Alex said she was happy that her friends made themselves available in case she needed help, but didn’t push her to talk.

Alex said she took a couple of friends out to lunch to explain she was going through a rough time, but didn’t want to talk about it. “They completely understood,” Alex said. “Because of that, I was more open with them over time.”

Alex’s friends helped her by keeping her busy. They brought her to coffee shops and to dinner, making sure she was up and out of her room.

“It can really help a lot.” Alex said. “When you’re alone, that’s when you have to face the voices in your head that are telling you something’s wrong with you or something’s going on.”

Alex’s sister — one of the few people that she had opened up to in the past — could tell that something was wrong after Alex heard the news of her grandmother’s illness. She pushed Alex to see a therapist — someone who wouldn’t judge her for talking about her problems.

“I [have] realized I don’t want to go through the next three years being upset all the time or being in this constant fight with myself,” Alex said. “So I‘m trying really hard to face the emotional demons and deal with them.” Following her sister’s advice, Alex decided to see a CAPS therapist, whom she continues to see now.

Lee, a College senior, only began seeing a CAPS therapist after his friends made an appointment on his behalf, concerned with what he told them about his depression.

While staying at Penn to do research last summer , he continued seeing his CAPS therapist. But when Lee started gathering supplies that he could use to take his own life, his CAPS therapist became worried.

“I went to CAPS, and I expressed my concerns that I didn’t think I could make it through the day,” he said. “They insisted that I had to go to the hospital.”

Lee was taken to a psychiatric ward in a hospital in Center City, where he was to stay indefinitely.

“Honestly, that was probably the worst experience of my life,” Lee said. “I was alone, I was more depressed than ever, I couldn’t kill myself because they took away everything I could use to hurt myself and I was locked in there.”

During his stay, Lee was diagnosed with severe clinical depression. He began taking antidepressants, but the medicine didn’t seem to help his symptoms. Lee started to fake feeling better in order to be released, and within a week he was sent home.

‘It’s OK not to be OK’

For some, the final decision to open up about mental illness ends in relief and, ultimately, provides a path for healing.

After her suicide attempt, Cam is now on her way to recovery — a process made easier with her mother by her side.

Cam’s mother had depression when she was younger, and Cam was unsure how she’d react to Cam’s own experiences. “I was scared to tell her because I was afraid she’d say, ‘You’re overreacting, you’re stressed,’ but I told her and she broke down and cried,” Cam said. “She said, ‘I just never want you to feel the way that I felt.’”

Cam’s mother gave her advice on how to cope with her depression and anorexia. “If anything, she was better than any psychologist. She was definitely a light for me, and I am so very fortunate to have her,” Cam said. “She was there for me every step of the way.”

With the support of her mother, Cam realized she didn’t have to hide anymore. She wanted to make everyone in her life aware of the way she felt, so she posted a Facebook status explaining everything — her depression, anorexia and suicide attempt — for all of her Facebook friends to see.

“I was scared — very scared of posting the status. I actually wrote it out, and then I almost clicked post but I got scared and I deleted it, and I went through that process a few times,” Cam said. “I was scared that people thought I was trying to get pity, and I didn’t want people to feel bad for me.”

When Cam fin ally posted her status, it received over 400 likes.

“I have been surprised with the amount of people who have come up to me after my Facebook status, telling me that they suffered from the same things as I did or they lost their father like I did,” Cam said. “I’m glad that me being able to create a voice made other people realize that it’s OK not to be OK.”

By posting her status, Cam said, she realized the importance of paying attention to the mental health of her friends and family.

“I want to be an advocate for students that things get better — I’m someone who has gone through it and survived it,” Cam said. “And I’ve come to the realization that maybe that’s the reason why I lived.”

Cam was part of the Spread the Love campaign earlier this semester, when a group of Penn students stood on Locust Walk handing out candy and asking people if they wanted hugs. She did it, she said, because she wanted to brighten the mood on campus after the recent suicides.

“Be there for your friends, ask if they’re OK, call them and tell them you love them,” Cam said. “Show your love and appreciation, because at the end of the day, they’re the reason why you’re sane.”

With the support of Alex’s therapist and her sister, Alex has come to a similar conclusion as Cam.

“Your relationships are the most important thing — your relationship with your family, with your friends and with yourself,” Alex said. “People don’t realize that.”

Alex has now begun to build her “Penn family” — her home away from home — which can fill in for the loved ones in her life who she can’t be with while she’s at school.

“There’s so much that people at Penn have to offer,” Alex said. “It’s OK to be vulnerable, and it’s OK to open up to these people at Penn. You’re going to find that there are a lot of similarities. They’re all questioning their self-confidence.”

Alex now understands that she has to confront her emot ions, she said, and she can’t do it without support from the people around her.

“When I was 12, when my mom passed, I wish that I could have understood that fact — that relationships are so important — because it’s hard to just rely on yourself,” Alex said. “You don’t realize how much someone else can impact your life.”

For Cam and Alex, the love and devotion of family and friends has helped them seek out treatment and work toward recovery. But for some people, like Lee, taking the step to talk about mental illness has led to more trouble.

“After getting out of the hospital, I figured that I had hit rock bottom. It was going to be nowhere but up from now — I had my bad experience,” Lee said. “But a few weeks after getting out of the hospital, I was getting more depressed again and more suicidal again, and I couldn’t really stop it and I couldn’t control it.”

Lee’s CAPS therapist was still concerned about his well-being. Toward the end of the summer, she told him that he should go to the hospital again. When she said that the police would have to escort him involuntarily to the hospital as a last resort, Lee stormed out of the office. That was the last time Lee ever set foot in CAPS, and he hasn’t seen a therapist since.

“I didn’t want to go through it again,” Lee said. “If they just take you and lock you in a room, that doesn’t make you feel better. You can’t hide from depression. You can put somebody in a room for a week, a month, however long — they’re going to feel the same way, if not worse.”

Lee said from then on he wanted nothing to do with CAPS or other administrators who tried to keep in touch with him periodically after he refused to return to treatment. He told them repeatedly that he was doing well, even though he wasn’t, until eventually they stopped checking in.

His situation with his friends is not much different, Lee said. When he talks about the way he feels, all his friends can do is encourage him to seek more help from a professional. “It felt like as soon as I really opened up about how I felt, everybody just wanted me to go to the hospital,” Lee said.

Lee continues to hurt himself, feel depressed and have suicidal thoughts and plans, but he now tries to keep them to himself as much as possible. He believes that as much as others try to help him, nothing they do can have an effect on the mental illness that has taken over his life.

“If there’s a rational way I could solve depression I would’ve done it already,” Lee said. “Depression is fundamentally irrational. It exists despite every other reason that it shouldn’t be there, and it doesn’t care what your reasons are and what your logic is — your flawless plan of getting better. It’s something that just gets into your head and stays there regardless.”

Lee said he doesn’t expect to see much improvement in his condition, but some times are better than others.

“I’ll probably be hurting myself for the rest of my life or end up committing suicide, and there’s not much I can do to stop that,” Lee said. “It’s just something I have to live with.”